Hi Team,

We have query related to understanding the calculation of cumulative days for denominator exclusion condition of CMS130v8:

Denominator Exclusions

Hospice."Has Hospice"
or exists "Malignant Neoplasm"
or exists "Total Colectomy Performed"
or FrailtyLTI."Advanced Illness and Frailty Exclusion Including Under Age 80"
or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where ( Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 65 )
and FrailtyLTI."Has Spent More Than 90 Days in Long Term Care

FrailtyLTI.Has Spent More Than 90 Days in Long Term Care

"Days Spent in Long Term Care During Measurement Period" > 90

FrailtyLTI.Days Spent in Long Term Care During Measurement Period

"CumulativeDays"("Long Term Care Periods During Measurement Period")

FrailtyLTI.Long Term Care Periods During Measurement Period

( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
union ["Encounter, Performed": "Nursing Facility Visit"] ) LongTermFacilityEncounter
where LongTermFacilityEncounter.relevantPeriod overlaps "Measurement Period"
return LongTermFacilityEncounter.relevantPeriod
intersect "Measurement Period"

For the above function please consider below cases for measurement period 01/01/2019 - 12/31/2019:

1. LongTermFacilityEncounter = 12/28/2018 - 01/04/2019

2. LongTermFacilityEncounter = 02/01/2019 - 02/06/2019

3. LongTermFacilityEncounter = 05/01/2019 - 05/06/2019

4. LongTermFacilityEncounter = 05/04/2019 - 05/07/2019

5. LongTermFacilityEncounter = 12/26/2019 - 01/03/2020

6. LongTermFacilityEncounter = 12/26/2019 - END DATE (NULL)

7. LongTermFacilityEncounter = 12/26/2018 - END DATE (NULL)

So while calculating the cumulative days for above LongTermFacility encounters below days will be taken into consideration i.e.,
1. 4 days (since 12/28/2018 - 12/31/2018 is before measurement period)
2. 6 days
3. 6 days
4. 1 day (since 05/04/2019 - 05/06/2019 is overlapping with the 3rd LongTermFacility encounter)
5. 6 days (since 01/01/2020 - 01/03/2020 is after measurement period)

6. & 7. These visits will not be considered as END DATE is NULL and to calculate cumulative days we need LongtermFacility.relevant period i.e., start and end date both

So the total cumulative days of LongtermFacility is (4+6+6+1+6) = 23 days

Request you to please confirm if our understanding is correct or not